This case traces the development of the voluntary medical male circumcision (VMMC) campaign in Nyanza Province, Kenya as it transformed from the subject of a randomized clinical trial into national policy. After providing some background on the cultural, political, and scientific context surrounding male circumcision, the case traces the PEPFAR-funded implementers' advances in delivering male circumcision in Nyanza. It examines the various delivery models used in Nyanza and the evolution of the relationship between implementers as well as on the development of the national strategic plan for VMMC released in 2009. The case ends with the implementers having come together successfully for two rapid, aggressive, 30-day implementation campaigns and the head of Kenya's National AIDS and Sexually Transmitted Infections Control Programme wrestling with how to make such campaigns sustainable and what lessons from the campaign to pass on to the national program. This is a condensed version of the case Voluntary Medical Male Circumcision in Nyanza Province, Kenya.

Learning Objectives: To understand how a randomized controlled trial may be translated into a large-scale public health program; how a surgical campaign was designed and implemented for rapid impact; the role of national and international collaboration in large-scale health delivery; and the ethical tradeoffs that arise in large-scale public health programs.

The case delves into the history of malaria control efforts in Zambia, including control and treatment policy changes in the in the early 2000s that set Zambia apart from other countries. Because by 2005 Zambia was still falling short of its targets, the National Malaria Control Center (NMCC) resolved to intensify its efforts by developing one national plan to improve coordination, data collection, partner involvement, and ultimately, rapidly scale-up interventions to meet the national malaria targets. The new NMCC director, Dr. Elizabeth Chizema, helped the program achieve success through several key interventions described in the case. With improved monitoring and evaluation, Chizema could demonstrate progress in malaria control, but she worried that partners might lose interest in helping Zambia given the low burden, and the program still had many challenges to overcome. This is a condensed version of the case Malaria Control in Zambia.

Learning Objectives: To understand the development of a successful malaria control program over time and the components that led to its success including the value of setting bold national goals, the merits of a health system with centralized governance and decentralized implementation, the importance of multiple coordinated interventions as opposed to a "silver bullet" approach for malaria control, and the use of data as an outcome measure, planning tool, and fundraising tool.